The Tallstick is a new, simplified anthropometric field tool which allows immediate visual interpretation of height-for-age. This tool was field tested in community-based programmes in Managua, Nicaragua, and the rural community of Los Zarzales, screening 1004 children aged 0-60 months for nutritional stunting. Overall sensitivity and specificity analysis comparing HAZ scores and Tallstick results revealed that the Tallstick correctly identified 83-85 per cent of severely stunted children (HAZ < -2.5) and two-thirds of those with HAZ of -2 and below. It also had good positive predictive value for the mildly stunted. As a screening tool for low weight-for-age, the Tallstick performed better than arm circumference. The best of the community volunteers trained with the Tallstick could use it as well as their trainers. Progressive stunting was found in the 280 children in the sample who did not receive any form of milk. The advantages of the Tallstick for community-level screening and the importance of sustained linear growth are discussed.

A new, simplified anthropometric field tool for detecting nutritional stunting, the "tallstick, " has been developed in community-based pilot programmes in Nicaragua and Nigeria. The folding stick, marked to indicate height-forage cutoff points for ages from birth to seven years below which the child is considered nutritionally stunted, is compared with arm circumference measurements as a simplified field tool. Sensitivity-specificity analyses contrasting the ability of height-forage and arm-circumference cutoff points to detect malnutrition showed height for age to be as good as arm circumference for detecting low weight for age, weaker for low weight for height, and stronger for a composite score of any degree of malnutrition in 1,070 children 0-72 months old in urban Managua with a prevalence of wasting of 0%-4%, of stunting of 17%-38%, and of underweight of 4%-22%. The importance of detecting stunting, the likelihood of reducing stunting rates, and the feasibility of using the tallstick and its variants are discussed.